Managed care organizations require primary care physicians to triage patients for skin cancer, yet many primary care physicians are unable to proficiently perform this function. Data suggest that primary care physicians correctly identify cancerous lesions less than 50% of the time, resulting in potentially disastrous health consequences for patients and increased health care costs. Triaging for skin cancer is a complex and difficult task, requiring primary care physicians to attend to important features of patients' skin lesions and history; sort these data; perform probability calculations; and follow complex lines of reasoning. Because computer programs can perform most of these functions faster and more reliably than physicians, such programs may help physicians triage for skin cancer. The goal of this project is to develop a prototype of a computer-based decision support tool to improve the accuracy of primary care physicians in triaging lesions suspicious for nonmelanoma skin cancer. During Phase I, we will develop a set of algorithms for triaging lesions suspicious for nonmelanoma skin cancer; develop a prototype of a computer-based decision support tool based on these algorithms; conduct a pilot test of the prototype with a sample of primary care physicians; analyze data; and write a final report. PROPOSED COMMERCIAL APPLICATION: This research is designed to produce a computer application that will be a commercially viable product. This computer-based decision support tool will improve patient health care while lowering health care costs. Potential purchasers of this product are managed health care organizations, primary care medical settings, and primary care physicians.